Early cardiovascular events in women with a history of gestational diabetes mellitus

Cardiovascular Diabetology

Original Investigation

Jonathan Cottenet¹  Karine Goueslard¹  Anne-Sophie Mariet¹  Catherine Quantin²  Jean-Michel Petit³  Maurice Giroud⁴  Yves Cottin⁵ 

[1] CHRU Dijon, Service de Biostatistique et d’Informatique Médicale (DIM), Université de Bourgogne, 21000, Dijon, France;CHRU Dijon, Service de Biostatistique et d’Informatique Médicale (DIM), Université de Bourgogne, 21000, Dijon, France;Clinical Investigation Center, clinical epidemiology/clinical trials unit, INSERM CIC 1432, Dijon University Hospital, 21000, Dijon, France;INSERM, UMR1181, Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Univ. Bourgogne Franche-Comté, 21000, Dijon, France;Centre de Recherche INSERM Unité 866, Univ. Bourgogne Franche-Comté, 21000, Dijon, France;Services de diabétologie et endocrinologie, CHRU Dijon, 21000, Dijon, France;Centre Hospitalier Universitaire, BP 77908, 21079, Dijon Cedex, France;Registre dijonnais des AVC, INSERM, INVS, EA4184, Univ. Bourgogne Franche-Comté, 21000, Dijon, France;Service de Cardiologie, CHRU Dijon, 21000, Dijon, France;

关键词: Gestational diabetes;    Diabetes mellitus;    Cardiovascular disease;    Coronary disease;   

DOI  :  10.1186/s12933-016-0338-0

 received in 2015-10-16, accepted in 2016-01-14,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe effect of gestational diabetes mellitus (GDM) on cardiovascular diseases (CVD) is not assessed within the first 10 years postpartum, regardless of subsequent diabetes. The aim of this study was to determine the risk of CVD events related to GDM within 7 years of postpartum.MethodsThis nationwide population-based study of deliveries in 2007 and 2008 with a follow-up of 7 years was based on data from the French medico-administrative database. Two groups were formed: women with a history of GDM and women without GDM or previous diabetes. CVD included angina pectoris, myocardial infarction, stroke, heart bypass surgery, coronary angioplasty, carotid endarterectomy and fibrinolysis. Hypertensive disease was assessed separately. Determinants studied included age, obesity, subsequent diabetes mellitus and hypertensive diseases during pregnancy. Adjusted odds ratios for outcomes were calculated using multiple logistic regressions.ResultsThe hospital database recorded 1,518,990 deliveries in 2007 and 2008. Among these, 62,958 women had a history of GDM. After adjusting for age, DM, obesity and hypertensive disorders in pregnancy, GDM was significantly associated with a higher risk of CVD (adjusted Odds Ratio aOR = 1.25 [1.09–1.43]). Considering each variable in a separate model, GDM was associated with angina pectoris (aOR = 1.68 [1.29–2.20]), myocardial infarction (aOR = 1.92 [1.36–2.71]) and hypertension (aOR = 2.72 [2.58–2.88]) but not with stroke.ConclusionsA history of GDM was identified as a risk factor of CVD, especially coronary vascular diseases, within the 7 years postpartum. A lifestyle changes from postpartum onwards can be recommended and supported.

【 授权许可】

CC BY   
© Goueslard et al. 2016